Project Summary The applicants propose a program of research, development, and evaluation of the use of consumers' assessments of health care for informing health care choices, assessing and promoting patient engagement, and quality improvement. The team will advance the science of consumer assessment of patient experience by, among other activities, refining questions to assess patient engagement and shared decision making that will be appropriate for patients with chronic, complex health issues. The applicants also will conduct a program of research on elicitation of patient narratives and develop narrative collection strategies that can be used with, and independently of, CAHPS surveys; broaden the approach for use with CAHPS surveys; and develop protocols for administering the narrative questions to low-income patients receiving complex care form team of clinicians, The team will then study how such information can best be provided to clinicians to facilitate improved patient-centered care. The team will also test new modes of data collection that have the potential of reducing survey costs and improving response rates. Another major activity will be to revise the CAHPS survey used to assess care experiences of individuals receiving care for behavioral health and substance use issues. The team will conduct three quality improvement studies, one on improving care coordination for patients with complex needs and two on improving patient engagement and shared decision making. The applicants will also develop internal and external communication strategies to advance the use of CAHPS surveys to improve quality of care.